Tibialis anterior tendon rupture associated with calcaneonavicular coalition
Presentation
Dropped a heavy object on foot two weeks ago. Now has foot swelling and reduced range of motion.
Patient Data
Subcutaneous edema at the anterior leg.
Tibialis anterior is completely ruptured. Both proximal and distal tendon fibers are thickened but more so distally with additional high signal extending to the insertion. The defect gap measures approximately 6-7 cm. The tendon at the myotendinous junction is also thickened with a mild amount of adjacent edema.
Extensor hallucis longus and extensor digitorum longus are intact. Extensor retinaculum appears intact.
Calcaneonavicular coalition (probably fibrous) with bone marrow edema signal and low T1 signal on both sides of the synchondrosis. Mild osteophytic lipping of the lateral talar head. Mild bone marrow edema through the talar neck and lateral body.
Case Discussion
This is a case of a traumatic tibialis anterior tendon rupture, on a background of tendinopathy, as well as a calcaneonavicular coalition. This is a rare association.
Tarsal coalitions can result in altered foot biomechanics 1, which could be a cause for the underlying tibialis anterior tendinopathy, increasing the risk of tendon rupture 2.
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